Effect of troglitazone on body fat distribution in type 2 diabetic patients
Effect of troglitazone on body fat distribution in type 2 diabetic patients
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DOI：
10.2337/diacare.22.6.908
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发表时间：
1999-06-01
期刊：
影响因子：
16.2
通讯作者：
Ikeda, Y
中科院分区：
文献类型：
--
作者：
Mori, Y;Murakawa, Y;Ikeda, Y
目的 - 最近报道曲格列酮在体外仅在皮下脂肪中特异性促进前脂肪细胞分化为脂肪细胞，表明曲格列酮改善胰岛素抵抗作用有关。为了扩展这一发现，我们在临床水平上研究了长期服用曲格列酮如何影响 2 型糖尿病患者的体脂分布。 研究设计和方法 - 对 30 名血糖控制不佳的 2 型糖尿病患者服用曲格列酮（400 毫克/天）6 个月。共有 18 名患者单独接受饮食治疗（在单一治疗组中，BMI 26.0 +/- 4.6，HbA(1c) 8.2 +/- 1.7%），12 名患者同时接受格列本脲（1.25-7.5 mg/天）（在联合磺脲类药物组中，BMI 25.4 +/- 4.7，HbA(1c) 9.2 +/- 1.2%）。测量并比较曲格列酮治疗前后通过脐部计算机断层扫描 (CT) 扫描确定的 BMI、HbA(1c)、血脂水平和体脂分布。 结果 - 在 6 个月的曲格列酮治疗期间，两组的 HbA(1c) 水平下降，BMI 增加。就体脂肪分布而言，单一治疗组的内脏脂肪面积（VFA）减少（从118.3 +/- 54.3至101.1 +/- 50.8 cm（2）；P < 0.001），皮下脂肪面积（SFA）增加（从189.7 +/- 93.3至221.6 +/- 101.6 cm2；P < 0.001）。 0.001），导致内脏/皮下（V/S）比率下降（从0.74 +/- 0.48到0.50 +/- 0.32；P < 0.001）。在同时使用磺脲类药物组中，VFA 没有变化（从 108.1 +/- 53.5 到 112.5 +/- 59.9 cm2），而 SFA 增加（从 144.6 +/- 122.0 到 180.5 +/- 143.5 cm2；P < 0.01），从而降低了 V/S 比（从 0.91 +/- 59.9 cm2）。 0.46 至 0.77 +/- 0.44；P < 0.01）。在单一治疗组中，75克口服葡萄糖耐量试验期间的血清甘油三酯水平和葡萄糖曲线下面积显着下降。 结论 - 根据我们的数据，曲格列酮似乎促进轻度肥胖日本 2 型糖尿病患者皮下脂肪组织而不是内脏脂肪组织的脂肪积累。这种能量积累从内脏脂肪组织到皮下脂肪组织的转变可能极大地有助于曲格列酮介导的胰岛素抵抗的改善。
OBJECTIVE - Troglitazone was recently reported to specifically promote the differentiation of pre-adipocytes into adipocytes in vitro in subcutaneous fat only, indicating a relation to insulin-resistance-improving action of troglitazone. To expand on this finding, we investigated at the clinical level how long-term administration of troglitazone influences the body fat distribution in type 2 diabetic patients.RESEARCH DESIGN AND METHODS - Troglitazone (400 mg/day) was administered for 6 months to 30 type 2 diabetic patients whose glycemic control was poor. A total of 18 patients received diet therapy alone (in the single-treatment group, BMI 26.0 +/- 4.6, HbA(1c) 8.2 +/- 1.7%), and 12 patients concomitantly received glibenclamide (1.25-7.5 mg/day) (in the concomitant sulfonylurea group, BMI 25.4 +/- 4.7, HbA(1c) 9.2 +/- 1.2%). BMI, HbA(1c), serum lipid level, and body fat distribution, which were determined by computed tomography (CT) scan at the umbilical level, were measured and compared before and after troglitazone treatment.RESULTS - During the 6-month troglitazone treatment, HbA(1c) levels decreased and BMI increased in both groups. As for body fat distribution in the single-treatment group, visceral fat area (VFA) decreased (from 118.3 +/- 54.3 to 101.1 +/- 50.8 cm(2); P < 0.001), and subcutaneous fat area (SFA) increased (from 189.7 +/- 93.3 to 221.6 +/- 101.6 cm2; P < 0.001), resulting in a decrease in visceral/subcutaneous (V/S) ratio (from 0.74 +/- 0.48 to 0.50 +/- 0.32; P < 0.001). In the concomitant sulfonylurea group, VFA was unchanged (from 108.1 +/- 53.5 to 112.5 +/- 59.9 cm2), while SFA increased (from 144.6 +/- 122.0 to 180.5 +/- 143.5 cm2; P < 0.01), thereby decreasing the V/S ratio (from 0.91 +/- 0.46 to 0.77 +/- 0.44; P < 0.01). The serum triglyceride level and the area under glucose curve during the 75-g oral glucose tolerance test decreased significantly in the single-treatment group.CONCLUSIONS - According to our data, troglitazone appears to promote fat accumulation in the subcutaneous adipose tissue rather than in the visceral adipose tissue in mildly obese Japanese people with type 2 diabetes. This shift of energy accumulation from the visceral to subcutaneous adipose tissue may greatly contribute to the troglitazone-mediated amelioration of insulin resistance.